D.C. Council gives first approval to amended PrEP insurance bill

‘This is a win in the fight against HIV/AIDS,’ said Council member Zachary Parker. (File photo courtesy of Earline Budd)

The D.C. Council voted unanimously on Feb. 3 to approve a bill on its first of two required votes that requires health insurance companies to cover the costs of HIV prevention or PrEP drugs for D.C. residents at risk for HIV infection.

 The vote to approve the PrEP D.C. Amendment Act came immediately after the 13-member Council voted unanimously again to approve an amendment that removed language in the bill added last month by the Council’s Committee on Health that would require insurers to fully cover only one PrEP drug.

The amendment, introduced jointly by Council members Zachary Parker (D-Ward 5), who first introduced the bill in February 2025, and Christina Henderson (I-At-Large), who serves as chair of the Health Committee, requires insurers to cover all U.S. Food and Drug Administration approved PrEP drugs.  

Under its rules, the D.C. Council must vote twice to approve all legislation, which must be signed by the D.C. mayor and undergo a 30-day review by Congress before it takes effect as a D.C. law.

Given its unanimous “first reading” vote of approval on Feb. 3, Parker told the Washington Blade he was certain the Council would approve the bill on its second and final vote expected in about two weeks.

Among those who raised concerns about the earlier version of the bill was Carl Schmid, executive director of the D.C.-based HIV+Hepatitis Policy Institute, who sent messages to all 13 Council members urging them to remove the language added by the Committee on Health requiring insurers to cover just one PrEP drug.

The change made by the committee, Schmidt told Council members, “would actually reduce PrEP options for D.C. residents that are required by current federal law, limit patient choice, and place D.C. behind states that have enacted HIV prevention policies designed to remain in effect regardless of any federal changes.”

Schmid told the Washington Blade that although coverage requirements for insurers are currently provided through coverage standards recommended in the U.S. Affordable Care Act, known as Obamacare, AIDS advocacy organizations have called on D.C. and states to pass their own legislation requiring insurance coverage of PrEP in the event that the federal policies are weakened or removed by the Trump administration, which has already reduced or ended federal funding for HIV/AIDS-related programs.

“The sticking point was the language in the markup that insurers only had to cover one regimen of PrEP,” Parker told the Blade in a phone interview the night before the Council vote. “And advocates thought that moved the needle back in terms of coverage access, and I agree with them,” he said.

In anticipation that the Council would vote to approve the amendment and the underlying bill, Parker, the Council’s only gay member, added, “I think this is a win for our community. And this is a win in the fight against HIV/AIDS.”

During the Feb. 3 Council session, Henderson called on her fellow Council members to approve both the amendment she and Parker had introduced and the bill itself. But she did not say why her committee approved the changes that advocates say weakened the bill and that her and Parker’s amendment would undo. Schmid speculated that pressure from insurance companies may have played a role in the committee change requiring coverage of only one PrEP drug. 

“My goal for advancing the ‘PrEP DC Amendment Act’ is to ensure that the District is building on the progress made in reducing new HIV infections every year,” Henderson said in a statement released after the Council vote. “On Friday, my office received concerns from advocates and community leaders about language regarding PrEP coverage,” she said.

“My team and I worked with Council member Parker, community leaders, including the HIV+Hepatitis Policy Institute and Whitman-Walker, and the Department of Insurance, Securities, and Banking, to craft a solution that clarifies our intent and provides greater access to these life-saving drugs for District residents by reducing consumer costs for any PrEP drug approved by the U.S. Food and Drug Administration,” her statement concludes.

In his own statement following the Council vote, Schmid thanked Henderson and Parker for initiating the amendment to improve the bill. “This will provide PrEP users with the opportunity to choose the best drug that meets their needs,” he said. “We look forward to the bill’s final reading and implementation.”

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